Our next talk is going to be prerecorded. It's Dr. Costas Kafalas, who will be speaking on the topic of leadership in GI practices. Costas is well known. He has been on the ASG Reimbursement Committee and on the MACRA Working Group. He is the medical director of the Digestive Health Center for Akron, Digestive Disease Consultants in Akron, Ohio, and is professor of internal medicine at Northeast Ohio Medical University. I hope you enjoy this. Hello, I'm Costas Kafalas, and it is my pleasure to present Leadership in GI Practices. I'd like to thank the course organizers for inviting me to speak, and ASG as well. I have no financial disclosures to report, and I serve on the following boards of directors and boards of trustees. There are a number of definitions of leadership, but one that I found most appropriate is by Kevin Cruz. Leadership is the process of social influence which maximizes the efforts of others toward the achievement of a goal. Leadership has nothing to do with seniority or one's position, nor does it have to do with titles. Leadership is not associated with personal attributes, and leadership isn't management. Leadership is all of the following, a trait, an ability, a skill, a behavior, a relationship, and of course an influence process where one individual influences a group of other individuals to achieve a common goal. There are five stages of leadership, and these progress from least advanced to most advanced. Position, permission, production, people development, and pinnacle. And as one advances through these stages, at the lower stage, people follow you because they have to or they want to. At the highest stage of leadership, the pinnacle, people follow you for who you are and what you represent. This slide lists six key leadership traits, intelligence, confidence, charisma, determination, sociability, and integrity. Qualities of a leader are listed on this slide, and there are many such lists, but this particular one lists defining, understanding, and implementing the mission, vision, and goals of the organization, setting an example of behavior, motivating others to action, communicating effectively, utilizing emotional intelligence, delegating responsibility, being accountable and having integrity, being humble, challenging the status quo, taking calculated risks and willing to fail, utilizing good judgment, being adaptable, managing conflict in the unpredictable, working hard, and of course enjoying leadership. Good leaders are the public face of an organization, and they articulate a vision and a mission. They create culture, they nourish and support the culture, they partake in strategic planning, they decide on what to focus, they select and develop people, they establish decision-making processes, and they are responsible 24-7. So most of us have seen this slide before. This is the classic seven leadership styles, and the styles listed include visionary, coaching, affiliative, democratic, pace-setting, and commanding. What's important to note is good leaders often utilize multiple leadership styles depending on the situation, and no one leadership style is right or wrong all of the time. In fact, most of these have to be utilized by effective leaders depending on the situation. So when there's a crisis, a commanding leadership style is often indicated, one which soothes fears by giving clear direction in an emergency. On the other hand, when the situation is stable and there are discussions regarding a new vision or direction, a visionary leadership style is often most effective, one in which the leader motivates people towards a shared goal or dream. Why be involved in leadership? Well, you can solve problems for your patients, your practice, you can create innovative solutions to problems others adopt, and you can increase the variety of responsibilities on your work life to avoid burnout. This is a summary slide of core leadership skills broken down into three categories. Administrative skills, which include managing people, managing resources, and demonstrating technical competence. This, of course, administrative skills is probably the most important of the three categories. The second category on the right of the slide is interpersonal skills, being socially perceptive, showing emotional intelligence, and managing interpersonal conflict. And lastly, conceptual skills, problem solving, strategic planning, and creating vision. These are core leadership skills for any leader. In terms of physician leaders, the traditional tasks have included articulating a vision and common objectives, trusting and listening to advice from others, understanding and appreciating new disciplines, focusing on the patient but having a broader perspective, and taking risks and accepting the unproven. Some contemporary tasks for physician leaders include integration, collaboration, engagement, influence, using analytics correctly and appropriately, and population health. Core competencies for physician leaders, whether it be in a practice setting or at the hospital or health system. These are from Dr. Sean Allen's summary from a few years ago in gastroenterology. Revenue cycle management, billing and coding, electric health records and portability, data security, quality metrics, payer negotiation, marketing and branding, operations, including implementation analysis and measurement, regulations, law and governance, human resources and regulation, and strategy and change management. So few are born leaders or have innate leadership skills, but leadership skills can be learned and honed over time, usually through a combination of experience, example, and education. So with respect to experiential learning, oftentimes this is more important than formal education. And this can be achieved by identifying a practice concern and developing a solution, serving on a practice hospital or health system committee, and serving on a regional, state, or national GI or medical society committee. On the other hand, didactic learning is formal coursework, which often results in a terminal degree of an MBA, MMM, MHA, MPH, MSHA, etc. And topics of this formal learning often include finance and education, business law, healthcare policy and regulation, operations management, etc. There are additional resources, including certain professional organizations and societies, that can offer didactic learning short of a formal degree, including the ASGE. So in 2021, we also need to think about features of inclusive leadership. And this slide lists six traits of such leadership. A visible commitment to diversity and inclusivity. Humility amongst leaders. Awareness of bias, not only of your own personal bias, but also flaws in the system. Curiosity about others. Cultural intelligence, being attentive to others' cultures and adapting as required. And effective collaboration. Well, how can a practice leader manage expectations? This slide is taken from the MGMA. Reviewing workplace culture and building strategy for physician and staff retention. Focusing on data and key performance indicators. Focusing on providing quality-based, value-based care. Creating and updating strategic plans, not only for the long term, but also for short-term goals. Exploring new reimbursement opportunities. Keeping up on MIPS reporting. Networking with other leaders. And staying up-to-date on changing rules, policies, and other regulations. Well, we've all gone through a significant disruption over the past year and a half, almost two years, in the COVID-19 pandemic. And thinking about how to help your practice recover, these are some points in the next few slides as well, cover some points and tips to make that happen. Getting things done regardless of who does it. Capitalizing on distributed leadership. Realizing the limits of your own expertise. And seeking needed help. So, when leading your practice through a crisis, plan. Be ready to shift gears. Communicate often and early. This cannot be overstated. Leading with compassion. Managing the post-crisis new normal. The new processes, strategies, and culture that have resulted from the crisis itself. So, here are 10 critical steps to help lead your practice through not only the current crisis, but future situations that may arise. Take ownership immediately. Stop the bleeding and minimize disruption on your operations. Assess the damage. Get the facts. Ask questions of right people. Separate the clutter and fiction from reality. This is so important. Dispel rumors and effectively communicate the next steps. We don't have much time for emotion, excuses, or blaming. The initial goal is to understand the real cause and make a plan to go forward. Set expectations and responsibilities in your practice for these initial tasks. The goal is to focus the staff on stabilizing the situation. Solicit input from your team to help you set realistic deadlines for completion of initial tasks. If anything can go wrong, it will. Keep your plan clear and updated and demand quick action when surprises appear. Be seen and be heard. Another important point in crisis management. As the leader, your presence is of utmost importance. Obtain understanding and buy-in from staff for the job to be done. Tell the truth and deal with facts. Return to business as usual. Once the crisis has passed, however, identify what you would have done differently. Acknowledge and reward the staff's hard work during the crisis. Help the staff learn from the experience. And, of course, there will be a next time. The most important aspect of a crisis is not the crisis, but how quickly and effectively you can lead your team to eliminate confusion and restore order. These are some characteristics of a resilient practice staff. Candor, resourcefulness, compassion and empathy, and humility. And one of the many blessings that's come out of the pandemic is really witnessing your staff members and how many of them have not only risen to the occasion, but exceeded the occasion with these characteristics. So to summarize, although some leaders possess innate qualities, most leaders require training. More than ever, GI practices require an able leader to successfully navigate the new normal post-COVID-19 and to prepare for the next crisis. Leaders should employ key specific skills during crisis management. And leadership that is based on sound skills and principles will often improve practice operations and achieve defined practice goals. Thank you very much.

leadership

GI practices

leadership progression

leadership traits

leadership styles